Transforming Global Surgery Capacity and Capability Through Affordable Virtual Reality

Summary

The goal of this randomized controlled trial was to evaluate whether Deliberate Virtual Reality (VR) training can improve surgical skills, knowledge, and confidence in performing postpartum hysterectomy among junior-level Zambian physicians in training.

The main questions it aims to answer are:

1. Can VR-based surgical training improve technical surgical skills in a real-world setting?
2. Does Deliberate VR training enhance knowledge retention and confidence compared to standard clinical training?

Study Design: Researchers randomly assigned participants to either:

1 Deliberate VR Training (intervention group): A 9-day VR-based surgical training program 2. Standard Training (control group): Conventional clinical education

Participants underwent assessments of surgical skills, knowledge, and confidence before and after training using objective structured assessment of technical skills (OSATS) and knowledge exams.

Key Findings:

1. The Deliberate VR group demonstrated significantly greater improvements in surgical knowledge, confidence, and OSATS scores compared to the standard training group.
2. VR training showed strong skill transfer to real-world surgical performance, suggesting that affordable and scalable VR training can help bridge surgical workforce gaps in resource-constrained settings.

This study highlights VR-based training as a potential scalable solution to strengthen surgical capacity in maternal health, addressing workforce shortages and improving equitable access to essential surgical care.

Conditions

• Hysterectomy (MeSH nr: E04.950.300.399)

Interventions

BEHAVIORAL

Deliberate Virtual Reality (VR) Training

Deliberate VR Training is a self-guided, interactive virtual reality-based training program focused on surgical skill acquisition. The VR simulation includes step-by-step procedural guidance, performance tracking, and self-reflection exercises for postpartum hysterectomy training. Participants practiced daily, receiving objective feedback on surgical accuracy and technique. The intervention lasted 9 days, with 6-hour daily training sessions.

BEHAVIORAL

Standard Clinical Training

Standard Clinical Training followed a traditional mentor-based surgical training model at tertiary hospitals. Training included clinical observation, procedural discussions, and hands-on practice under supervision. Unlike the Deliberate VR group, participants did not have access to structured virtual reality simulation during the initial phase. Following post-training assessment, all participants in this arm crossed over to complete the Deliberate VR Training program. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Sponsors & Collaborators

• King's College London

  collaborator OTHER

• Southern Methodist University

  lead OTHER

Principal Investigators

• Richard Sullivan, MD, PhD · King's College London

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Model

CROSSOVER

Eligibility

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2021-09-01

Primary Completion

2021-12-31

Completion

2021-12-31

Countries

• Zambia

Study Locations